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Mathias N, Huille S, Picci M, Mahoney RP, Pettis RJ, Case B, Helk B, Kang D, Shah R, Ma J, Bhattacharya D, Krishnamachari Y, Doucet D, Maksimovikj N, Babaee S, Garidel P, Esfandiary R, Gandhi R. Towards more tolerable subcutaneous administration: Review of contributing factors for improving combination product design. Adv Drug Deliv Rev 2024; 209:115301. [PMID: 38570141 DOI: 10.1016/j.addr.2024.115301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
Subcutaneous (SC) injections can be associated with local pain and discomfort that is subjective and may affect treatment adherence and overall patient experience. With innovations increasingly focused on finding ways to deliver higher doses and volumes (≥2 mL), there is a need to better understand the multiple intertwined factors that influence pain upon SC injection. As a priority for the SC Drug Development & Delivery Consortium, this manuscript provides a comprehensive review of known attributes from published literature that contribute to pain/discomfort upon SC injection from three perspectives: (1) device and delivery factors that cause physical pain, (2) formulation factors that trigger pain responses, and (3) human factors impacting pain perception. Leveraging the Consortium's collective expertise, we provide an assessment of the comparative and interdependent factors likely to impact SC injection pain. In addition, we offer expert insights and future perspectives to fill identified gaps in knowledge to help advance the development of patient-centric and well tolerated high-dose/high-volume SC drug delivery solutions.
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Affiliation(s)
- Neil Mathias
- Bristol-Myers Squibb, Co., 1 Squibb Dr, New Brunswick, NJ, 08901 USA
| | - Sylvain Huille
- Sanofi, 13 quai Jules Guesde, 94400 Vitry-Sur-Seine, France.
| | - Marie Picci
- Novartis Pharma AG, Fabrikstrasse 4, CH-4056 Basel, Switzerland
| | - Robert P Mahoney
- Comera Life Sciences, 12 Gill St, Suite 4650, Woburn, MA 01801 USA
| | - Ronald J Pettis
- Becton-Dickinson, 21 Davis Drive, Research Triangle Park, NC 27513 USA
| | - Brian Case
- KORU Medical Systems, 100 Corporate Dr, Mahwah, NJ 07430 USA
| | - Bernhard Helk
- Novartis Pharma AG, Werk Klybeck, WKL-681.4.42, CH-4057 Basel, Switzerland
| | - David Kang
- Halozyme Therapeutics, Inc., 12390 El Camino Real, San Diego, CA 92130 USA
| | - Ronak Shah
- Bristol-Myers Squibb, Co., 1 Squibb Dr, New Brunswick, NJ, 08901 USA
| | - Junchi Ma
- Johnson & Johnson Innovative Medicine, 200 Great Valley Pkwy, Malvern, PA 19355 USA
| | | | | | - Dany Doucet
- GSK, 1250 South Collegeville Road, Collegeville, PA 19426 USA
| | | | - Sahab Babaee
- Merck & Co., Inc., 126 E. Lincoln Ave., Rahway, NJ 07065 USA
| | - Patrick Garidel
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Straße 65, 88397 Biberach/Riss, Germany
| | | | - Rajesh Gandhi
- Bristol-Myers Squibb, Co., 1 Squibb Dr, New Brunswick, NJ, 08901 USA
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Fragoso NM, Masson R, Gillenwater TJ, Shi VY, Hsiao JL. Emerging Treatments and the Clinical Trial Landscape for Hidradenitis Suppurativa Part I: Topical and Systemic Medical Therapies. Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00956-6. [PMID: 37402031 PMCID: PMC10366071 DOI: 10.1007/s13555-023-00956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/01/2023] [Indexed: 07/05/2023] Open
Abstract
Hidradenitis suppurativa (HS) is an oftentimes debilitating condition that presents with painful nodules, abscesses, and sinus tracts. This condition is challenging to treat, in part because the pathogenesis of the condition is incompletely understood but also because there are limited therapeutic options. HS research is undergoing explosive growth with multiple new molecular pathways under study, which will hopefully lead to improved disease control for patients. Part I of this review will provide an overview of the emerging topical and systemic therapies under investigation for HS.
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Affiliation(s)
- Natalie M Fragoso
- Department of Dermatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Rahul Masson
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - T Justin Gillenwater
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA, USA
| | - Vivian Y Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer L Hsiao
- Department of Dermatology, University of Southern California, 1441 Eastlake Ave, Ezralow Tower, Suite 5301, Los Angeles, CA, 90089, USA.
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Wynne C, Schwabe C, Stroissnig H, Dias R, Sobierska J, Guenzi E, Otto H, Sattar A, Haliduola HN, Edwald E, Berti F. A multicenter, randomized, open-label, 2-arm parallel study to compare the pharmacokinetics, safety and tolerability of AVT02 administered subcutaneously via prefilled syringe or autoinjector in healthy adults. Expert Opin Biol Ther 2023; 23:773-780. [PMID: 36197309 DOI: 10.1080/14712598.2022.2131391] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/28/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND AVT02 is an adalimumab biosimilar, with bioequivalence previously established along with clinical similarity. This study assessed the pharmacokinetic (PK) similarity of a single dose of 100 mg/mL AVT02 administered via prefilled syringe (PFS) or autoinjector (AI). RESEARCH DESIGN AND METHODS In this open-label, 2-arm, parallel-group study, healthy adults were randomized 1:1 to receive one 40 mg (100 mg/mL) dose of AVT02 subcutaneously via PFS (N = 102) or AI (N = 105). Primary PK parameters (Cmax, AUC0-t and AUC0-inf) were evaluated up to Day 64 of the study. Secondary PK parameters, safety, tolerability and immunogenicity were also assessed. RESULTS The 90% CIs for the ratio of geometric least squares means were contained within the pre-specified 80-125% equivalence margins for the primary PK parameters, demonstrating bioequivalence of AVT02 when administered by PFS or AI. The incidence of treatment-emergent adverse events was comparable between the two groups, with a low frequency of injection site reactions observed. Immunogenicity profiles were also similar between the two groups. CONCLUSION Bioequivalence was demonstrated for a single dose of AVT02 administered via PFS or AI. These results will help to increase availability of devices for patients, enabling treatment choice and flexibility.
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Affiliation(s)
- Christopher Wynne
- Biosimilar Trials, New Zealand Clinical Research, Christchurch, New Zealand
| | - Christian Schwabe
- Biosimilar Trials, New Zealand Clinical Research, Auckland, New Zealand
| | - Heimo Stroissnig
- Clinical and Medical Affairs, Alvotech Germany GmbH, Jülich, Germany
| | - Roshan Dias
- Clinical and Medical Affairs, Alvotech Swiss AG, Zürich, Switzerland
| | - Joanna Sobierska
- Clinical and Medical Affairs, Alvotech Swiss AG, Zürich, Switzerland
| | - Eric Guenzi
- Preclinical Development and Project Management, UGA Biopharma GmbH, Hennigsdorf, Germany
| | - Hendrik Otto
- Clinical and Medical Affairs, Alvotech Germany GmbH, Jülich, Germany
| | - Abid Sattar
- Clinical and Medical Affairs, Alvotech UK Ltd, London, UK
| | | | - Elin Edwald
- Combination Products & Devices, Alvotech Iceland, Reykjavik, Iceland
| | - Fausto Berti
- Clinical and Medical Affairs, Alvotech Swiss AG, Zürich, Switzerland
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Nikam RV, Gowtham M, More PS, Shinde AS. Current and emerging prospects in the psoriatic treatment. Int Immunopharmacol 2023; 120:110331. [PMID: 37210912 DOI: 10.1016/j.intimp.2023.110331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 05/23/2023]
Abstract
Psoriasis is an autoimmune chronic disorder that causes inflammation and a scaly epidermis. The exact pathogenesis of the disease is not known yet. According to the studies, psoriasis is considered an immune-mediated disease. Until now it is believed that genetic and environmental factors are responsible for the disease. There are many comorbidities associated with psoriasis which increases difficulties as patients in some cases get addicted to drugs, alcohol, and smoking which reduces their quality of life. The patient may face social ignorance or suicidal thoughts which may arise in the patient's mind. Due to the undefined trigger of the disease, the treatment is not fully established but by considering the severe impact of the disease researchers are focusing on novel approaches for successful treatment. which has succeeded to a large extent. Here we review pathogenesis, problems faced by psoriatic patients, the need for the development of new treatments over conventional therapies, and the history of psoriatic treatments. We thoroughly focus on emerging treatments like biologics, biosimilars, and small molecules which are now showing more efficacy and safety than conventional treatments. Also, this review article discusses novel approaches which are now in research such as drug repurposing, treatment by stimulation of the vagus nerve, regulation of microbiota, and autophagy for improving disease conditions.
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Affiliation(s)
- Rutuja Vilas Nikam
- Department of Pharmaceutics, Sanjivani College of Pharmaceutical Education and Research, At Sahajanandnagar, Post-Shinganapur, Tal-Kopargaon, Dist-Ahmednagar, Maharashtra 423603, India.
| | - M Gowtham
- Department of Pharmaceutics, Sanjivani College of Pharmaceutical Education and Research, At Sahajanandnagar, Post-Shinganapur, Tal-Kopargaon, Dist-Ahmednagar, Maharashtra 423603, India.
| | - Pratiksha Sanjay More
- Department of Pharmaceutics, Sanjivani College of Pharmaceutical Education and Research, At Sahajanandnagar, Post-Shinganapur, Tal-Kopargaon, Dist-Ahmednagar, Maharashtra 423603, India.
| | - Anuja Sanjay Shinde
- Department of Pharmaceutics, Sanjivani College of Pharmaceutical Education and Research, At Sahajanandnagar, Post-Shinganapur, Tal-Kopargaon, Dist-Ahmednagar, Maharashtra 423603, India.
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Tomaszewska-Kiecana M, Dryja A, Ullmann M, Petit-Frere C, Illes A, Dagres C, Monnet J. Pharmacokinetics and tolerability of prefilled syringe and auto-injector presentations of MSB11456: results of a randomized, single-dose study in healthy adults. Expert Rev Clin Immunol 2023; 19:447-455. [PMID: 36789991 DOI: 10.1080/1744666x.2023.2174970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Tocilizumab is a monoclonal immunoglobulin G interleukin-6 receptor antagonist. MSB11456 is a proposed tocilizumab biosimilar. OBJECTIVE To determine the pharmacokinetic equivalence of a single subcutaneous injection of MSB11456, when delivered via autoinjector (AI) and prefilled syringe (PFS), in healthy adult subjects. RESEARCH DESIGN AND METHODS In this randomized, open-label, single fixed-dose, crossover study, 91 subjects received subcutaneous administration of tocilizumab 162 mg via AI and PFS presentations. The primary endpoint pharmacokinetic parameters were analyzed using analysis of variance. Safety data were summarized descriptively. RESULTS There were no differences in pharmacokinetic parameters between presentations, and safety parameters were comparable. The 90% confidence intervals for the geometric least squares mean ratios of all primary pharmacokinetic parameters were contained within the predefined 80.00% to 125.00% bioequivalence limits, indicating pharmacokinetic equivalence between the AI and PFS. CONCLUSIONS MSB11456 administration via AI was bioequivalent to administration via PFS. MSB11456 can be administered by AI or PFS, increasing the available range of self-injection devices. TRIAL REGISTRATION The trial is registered at EudraCT, number 2020-003419-86.
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Affiliation(s)
| | - Anna Dryja
- MTZ Clinical Research Sp Z O O, Warsaw, Poland
| | | | | | - Andras Illes
- Biosimilars, Fresenius Kabi SwissBioSim, Switzerland
| | | | - Joëlle Monnet
- Biosimilars, Fresenius Kabi SwissBioSim, Switzerland
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